2.50
Hdl Handle:
http://hdl.handle.net/2336/48754
Title:
Orthogonal polarization spectroscopy to detect mesenteric hypoperfusion.
Authors:
Bracht, Hendrik; Krejci, Vladimir; Hiltebrand, Luzius; Brandt, Sebastian; Sigurdsson, Gisli; Ali, Syed Z; Takala, Jukka; Jakob, Stephan M
Citation:
Intensive Care Med. 2008, 34(10):1883-90
Issue Date:
1-Oct-2008
Abstract:
OBJECTIVE: Orthogonal polarization spectral (OPS) imaging is used to assess mucosal microcirculation. We tested sensitivity and variability of OPS in the assessment of mesenteric blood flow (Qsma) reduction. SETTING: University Animal Laboratory. INTERVENTIONS: In eight pigs, Qsma was reduced in steps of 15% from baseline; five animals served as controls. Jejunal mucosal microcirculatory blood flow was recorded with OPS and laser Doppler flowmetry at each step. OPS data from each period were collected and randomly ordered. Samples from each period were individually chosen by two blinded investigators and quantified [capillary density (number of vessels crossing predefined lines), number of perfused villi] after agreement on the methodology. MEASUREMENT AND RESULTS: Interobserver coefficient of variation (CV) for capillary density from samples representing the same flow condition was 0.34 (0.04-1.41) and intraobserver CV was 0.10 (0.02-0.61). Only one investigator observed a decrease in capillary density [to 62% (48-82%) of baseline values at 45% Qsma reduction; P = 0.011], but comparisons with controls never revealed significant differences. In contrast, reduction in perfused villi was detected by both investigators at 75% of mesenteric blood flow reduction. Laser Doppler flow revealed heterogeneous microcirculatory perfusion. CONCLUSIONS: Assessment of capillary density did not reveal differences between animals with and without Qsma reduction, and evaluation of perfused villi revealed blood flow reduction only when Qsma was very low. Potential explanations are blood flow redistribution and heterogeneity, and suboptimal contrast of OPS images. Despite agreement on the method of analysis, interobserver differences in the quantification of vessel density on gut mucosa using OPS are high.
Description:
To access publisher full text version of this article. Please click on the hyperlink in Additional Links field
Additional Links:
http://www.springerlink.com/content/v51100r5l0m13320

Full metadata record

DC FieldValue Language
dc.contributor.authorBracht, Hendrik-
dc.contributor.authorKrejci, Vladimir-
dc.contributor.authorHiltebrand, Luzius-
dc.contributor.authorBrandt, Sebastian-
dc.contributor.authorSigurdsson, Gisli-
dc.contributor.authorAli, Syed Z-
dc.contributor.authorTakala, Jukka-
dc.contributor.authorJakob, Stephan M-
dc.date.accessioned2009-02-09T15:02:38Z-
dc.date.available2009-02-09T15:02:38Z-
dc.date.issued2008-10-01-
dc.date.submitted2009-02-09-
dc.identifier.citationIntensive Care Med. 2008, 34(10):1883-90en
dc.identifier.issn0342-4642-
dc.identifier.pmid18516589-
dc.identifier.doi10.1007/s00134-008-1130-8-
dc.identifier.urihttp://hdl.handle.net/2336/48754-
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractOBJECTIVE: Orthogonal polarization spectral (OPS) imaging is used to assess mucosal microcirculation. We tested sensitivity and variability of OPS in the assessment of mesenteric blood flow (Qsma) reduction. SETTING: University Animal Laboratory. INTERVENTIONS: In eight pigs, Qsma was reduced in steps of 15% from baseline; five animals served as controls. Jejunal mucosal microcirculatory blood flow was recorded with OPS and laser Doppler flowmetry at each step. OPS data from each period were collected and randomly ordered. Samples from each period were individually chosen by two blinded investigators and quantified [capillary density (number of vessels crossing predefined lines), number of perfused villi] after agreement on the methodology. MEASUREMENT AND RESULTS: Interobserver coefficient of variation (CV) for capillary density from samples representing the same flow condition was 0.34 (0.04-1.41) and intraobserver CV was 0.10 (0.02-0.61). Only one investigator observed a decrease in capillary density [to 62% (48-82%) of baseline values at 45% Qsma reduction; P = 0.011], but comparisons with controls never revealed significant differences. In contrast, reduction in perfused villi was detected by both investigators at 75% of mesenteric blood flow reduction. Laser Doppler flow revealed heterogeneous microcirculatory perfusion. CONCLUSIONS: Assessment of capillary density did not reveal differences between animals with and without Qsma reduction, and evaluation of perfused villi revealed blood flow reduction only when Qsma was very low. Potential explanations are blood flow redistribution and heterogeneity, and suboptimal contrast of OPS images. Despite agreement on the method of analysis, interobserver differences in the quantification of vessel density on gut mucosa using OPS are high.en
dc.language.isoenen
dc.publisherSpringer Verlagen
dc.relation.urlhttp://www.springerlink.com/content/v51100r5l0m13320en
dc.subject.meshPubMed - in processen
dc.titleOrthogonal polarization spectroscopy to detect mesenteric hypoperfusion.en
dc.typeArticleen
dc.contributor.departmentDepartment of Intensive Care Medicine, Bern University Hospital and University of Bern, Inselspital, CH-3010 Bern, Switzerland.en
dc.identifier.journalIntensive care medicineen

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